Necessary Pain?

May 14, 1996

You might say personal-injury lawyers are feeling the lash of The Lancet.

In an era when a tiny slice of the American electorate - plaintiff's lawyers - are vetoing legislation through massive political contributions and backstage lobbying, it's of more than passing interest to see a rebuke from the scientific community.

This comes in the form of a study of whiplash published in the British medical journal, The Lancet.

A team of Norwegian researchers studied the cases of 202 Lithuanian drivers involved in rear-ended car accidents of varying seriousness. Those studied reported an incidence of neck and headache problems similar to that of a control group not involved in auto accidents. But in no case did any of the collision victims report the kind of persisting pain known in lawsuits as whiplash.

Almost no private auto insurance is available in Lithuania. And people generally haven't heard of whiplash. So the researchers drew the undeniably logical conclusion that chronic whiplash exists only where people are mentally conditioned to expect and/or benefit financially from it. And also where the insurance and legal system provides a framework to nourish its supposed existence.

Not surprisingly, when the study results were announced, Dr. Harald Schrader, a hospital neurologist on the research team, was threatened with suit by the head of a whiplash-patients organization in Norway. (There are some 70,000 people in that organization who claim chronic disability.)

No one, of course, should suggest singling out the victims for blame. A whole system is geared to reinforce their belief in their continuing infirmity. That system includes well-intentioned lawmakers, fee-seeking lawyers, and busy (and sometimes unethical) health-care providers.

But the study in Lithuania provides a healthy reminder to Western societies that a heavy price is paid when a culture of self-imposed victimhood and self-serving litigation develops.

One part of that price appears in impersonal numbers: lost efficiency, soaring costs, unfair usurpation of health-care resources. But a far more tragic cost is personal: individuals shackled for years by their belief that inescapable pain rules their lives day after day. Instead of threatening suit, those people might spare a word of gratitude to Dr. Shrader and his colleagues. His team offers them the beginning of knowledge to set them free.